David Healy: Shipwreck of the Singular

Barry Blackwell’s comment on Donald F. Klein’s comment

I was surprised to read Don Klein’s comment on “Shipwreck of the Singular” in which he regrets that responses to date have suggested no recommendations for “actually achieving how to better this parlous state.”

Perhaps this is because Don, like David, is obsessed with viewing the problem from an esoteric philosophical and societal perspective (Utopian and Scientific Socialism) rather than a pragmatic problem relating to the contemporary practice of health care including – as I have pointed out – the failure of medical education to adequately prepare physicians to practice a biopsychosocial model of medicine and subsequently resist the siren call of profit and greed that have eroded the Hippocratic empathic and benevolent ideal. Insurance companies and Health Care Corporations have replaced that with a bottom line ideology (masquerading as “not for profit”) that is destroying independent medical practice, replacing it with salaried employees (hospitalists, primary care physicians, psychiatrists and others) whose practice is controlled by “productivity ratios”. A profession with once generous ideals and political clout has become impotent and in thrall to the twin deities of Midas and Mammon.

But, in the end, we might all agree with both the diagnosis and potential cure for this problem. To restore our professions attention to the public’s singular needs we both must shed our ambivalence towards universal health care and express that preference at the ballot box – perhaps “Scientific Socialism” in practice?